Pathophysiological mechanisms of liver injury in COVID‐19

Liver International, Journal Year: 2020, Volume and Issue: 41(1), P. 20 - 32

Published: Nov. 15, 2020

The recent outbreak of coronavirus disease 2019 (COVID-19), caused by the Severe Acute Respiratory Syndrome Coronavirus-2 (SARS-CoV-2) has resulted in a world-wide pandemic. Disseminated lung injury with development acute respiratory distress syndrome (ARDS) is main cause mortality COVID-19. Although liver failure does not seem to occur absence pre-existing disease, hepatic involvement COVID-19 may correlate overall severity and serve as prognostic factor for ARDS. spectrum range from direct infection SARS-CoV-2, indirect systemic inflammation, hypoxic changes, iatrogenic causes such drugs ventilation exacerbation underlying disease. This concise review discusses potential pathophysiological mechanisms SARS-CoV-2 tropism well possibly long-term

Language: Английский

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Molecular consequences of SARS-CoV-2 liver tropism

Nature Metabolism, Journal Year: 2022, Volume and Issue: 4(3), P. 310 - 319

Published: March 28, 2022

Extrapulmonary manifestations of COVID-19 have gained attention due to their links clinical outcomes and potential long-term sequelae1. Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) displays tropism towards several organs, including the heart kidney. Whether it also directly affects liver has been debated2,3. Here we provide clinical, histopathological, molecular bioinformatic evidence for hepatic SARS-CoV-2. We find that injury, indicated by a high frequency abnormal function tests, is common feature in two independent cohorts patients with requiring hospitalization. Using autopsy samples obtained from third patient cohort, multiple levels SARS-CoV-2 tropism, viral RNA detection 69% specimens, successful isolation infectious tissue postmortem. Furthermore, identify transcription-, proteomic- transcription factor-based activity profiles samples, revealing similarities signatures associated other infections human liver. Together, comprehensive multimodal analysis which increases our understanding consequences severe could be useful identification organ-specific pharmacological targets.

Language: Английский

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Acute Liver Failure Guidelines

The American Journal of Gastroenterology, Journal Year: 2023, Volume and Issue: 118(7), P. 1128 - 1153

Published: March 20, 2023

Acute liver failure (ALF) is a rare, acute, potentially reversible condition resulting in severe impairment and rapid clinical deterioration patients without preexisting disease. Due to the rarity of this condition, published studies are limited by use retrospective or prospective cohorts lack randomized controlled trials. Current guidelines represent suggested approach identification, treatment, management ALF official practice recommendations American College Gastroenterology. The scientific evidence was reviewed using Grading Recommendations, Assessment, Development Evaluation process develop recommendations. When no robust available, expert opinions were summarized Key Concepts. Considering variety presentations ALF, individualization care should be applied specific scenarios.

Language: Английский

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COVID-19 and liver disease

Gut, Journal Year: 2022, Volume and Issue: 71(11), P. 2350 - 2362

Published: June 14, 2022

Knowledge on SARS-CoV-2 infection and its resultant COVID-19 in liver diseases has rapidly increased during the pandemic. Hereby, we review manifestations pathophysiological aspects related to patients without disease as well impact of with chronic (CLD), particularly cirrhosis transplantation (LT). been associated overt proinflammatory cytokine profile, which probably contributes substantially observed early late abnormalities. CLD, decompensated cirrhosis, should be regarded a risk factor for severe death. LT was impacted pandemic, mainly due concerns regarding donation recipients. However, did not represent per se worse outcome. Even though scarce, data specific therapy special populations such recipients seem promising. vaccine-induced immunity seems impaired CLD recipients, advocating revised schedule vaccine administration this population.

Language: Английский

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Secondary sclerosing cholangitis as cause of persistent jaundice in patients with severe COVID‐19

Liver International, Journal Year: 2021, Volume and Issue: 41(10), P. 2404 - 2417

Published: May 21, 2021

Little is known about cholestasis, including its most severe variant secondary sclerosing cholangitis (SSC), in critically ill patients with coronavirus disease 19 (COVID-19). In this study, we analysed the occurrence of cholestatic liver injury and SSC, clinical, serological, radiological histopathological findings.We conducted a retrospective single-centre analysis all consecutive admitted to intensive care unit (ICU) as result COVID-19 at University Hospital Zurich describe these patients. The findings were compared cohort influenza A.A total 34 ICU included. Of these, 14 (41%) had no cholestasis (group 0), 11 (32%, group 1) developed mild 9 (27%, 2) cholestasis. Patients 2 more complicated course indicated by significantly longer stay (median 51 days, IQR 25-86.5) than other groups 0: median 9.5 3.8-18.3, P = .001; 1: 16 8-30, < .05 respectively). Four SSC none A cohort. available suggest an ischaemic damage perihilar bile ducts.The development represents important complication needs be considered diagnostic work up prolonged interest ongoing pandemic since it associated considerable morbidity mortality.

Language: Английский

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Diverse Immunological Factors Influencing Pathogenesis in Patients with COVID-19: A Review on Viral Dissemination, Immunotherapeutic Options to Counter Cytokine Storm and Inflammatory Responses

Pathogens, Journal Year: 2021, Volume and Issue: 10(5), P. 565 - 565

Published: May 7, 2021

The pathogenesis of coronavirus disease 2019 (COVID-19), caused by severe acute respiratory syndrome 2 (SARS-CoV-2), is still not fully unraveled. Though preventive vaccines and treatment methods are out on the market, a specific cure for has been discovered. Recent investigations research studies primarily focus immunopathology disease. A healthy immune system responds immediately after viral entry, causing immediate annihilation recovery. However, an impaired causes extensive systemic damage due to unregulated response characterized hypersecretion chemokines cytokines. elevated levels cytokine or hypercytokinemia leads distress (ARDS) along with multiple organ damage. Moreover, against SARS-CoV-2 linked race, gender, age; hence, this infection's outcome differs among patients. Many therapeutic strategies focusing immunomodulation have tested assuage storm in patients COVID-19. thorough understanding diverse signaling pathways triggered virus essential before contemplating relief measures. This present review explains interrelationships hyperinflammatory severity. Furthermore, we thrown light mechanisms risk factors that influence molecular lead infection Recognition altered dysregulated can be loophole identify potential target markers. Identifying biomarkers pathway aid better clinical management COVID-19 special also given potent inhibitors proinflammatory cytokines, immunomodulatory immunotherapeutic options ameliorate inflammatory responses affected

Language: Английский

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Gastrointestinal Manifestations of COVID-19: A Review of What We Know

Ochsner Journal, Journal Year: 2021, Volume and Issue: 21(2), P. 177 - 180

Published: Jan. 1, 2021

Background: The coronavirus disease 2019 (COVID-19) is not just a of the respiratory system. virus can affect gastrointestinal (GI) tract as well. Recognizing various manifestations in every organ system important because these contribute to community-based transmission. Methods: We outline evidence pathophysiology COVID-19 GI tract, effects on gut and liver, presence stool samples, potential for fecal-oral transmission COVID-19. Most literature sources used this paper are case studies from China following surge infection. Results: In patients with COVID-19, symptoms such anorexia, nausea, vomiting, diarrhea, abdominal pain have presented conjunction fever, shortness breath, cough. Evidence also shows acute hepatocellular injury, indicated by elevated liver enzymes alanine aminotransferase, aspartate gamma-glutamyl transferase. Fecal-oral suspected RNA samples COVID-19–positive patients. Conclusion: Even without symptoms, several associated infection, well possible Therefore, infection should be considered presenting primarily symptoms.

Language: Английский

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Progressive cholestasis and associated sclerosing cholangitis are frequent complications of COVID‐19 in patients with chronic liver disease

Hepatology, Journal Year: 2022, Volume and Issue: 76(6), P. 1563 - 1575

Published: May 21, 2022

Abstract Background and Aims Cholestasis is associated with disease severity worse outcome in COVID‐19. Cases of secondary sclerosing cholangitis (SSC) after severe acute respiratory syndrome coronavirus 2 (SARS‐CoV‐2) infection have been described. Approach Results Hospitalized patients COVID‐19 between 03/2020 07/2021 were included. Patients stratified as having (i) no chronic liver (CLD), (ii) non‐advanced CLD (non‐ACLD), or (iii) advanced (ACLD). non–COVID‐19 pneumonia matched to a control cohort. Liver chemistries before (Pre) at first, second, third blood withdrawal SARS‐CoV‐2 (T1–T3) last available time point (last) recorded. A total 496 In total, 13.1% ( n = 65) had (non‐ACLD: 70.8%; ACLD: 29.2%); the predominant etiology was NAFLD/NASH (60.0%). COVID‐19–related injury more common among (24.6% vs. 10.6%; p 0.001). After infection, exhibited progressive cholestasis persistently increasing levels alkaline phosphatase (Pre: 91.0 T1: 121.0 last: 175.0 U/L; < 0.001) gamma‐glutamyl transferase 95.0 135.0 202.0 23.1% 15/65) developed cholestatic failure (cholestasis plus bilirubin ≥6 mg/dl) during COVID‐19, 15.4% 10/65) SSC. SSC significantly frequent than 0.040). COVID‐19–associated occurred predominantly metabolic risk factors. 26.3% 5/19) ACLD experienced hepatic decompensation infection. Conclusions About 20% develop factors are particular for developing and/or

Language: Английский

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Targeted metabolomics identifies high performing diagnostic and prognostic biomarkers for COVID-19

Scientific Reports, Journal Year: 2021, Volume and Issue: 11(1)

Published: July 19, 2021

Research exploring the development and outcome of COVID-19 infections has led to need find better diagnostic prognostic biomarkers. This cross-sectional study used targeted metabolomics identify potential biomarkers that predicted course illness by assessing 110 endogenous plasma metabolites from individuals admitted a local hospital for diagnosis/treatment. Patients were classified into four groups (≈ 40 each) according standard polymerase chain reaction (PCR) testing disease course: PCR-/controls (i.e., non-COVID controls), PCR+/not-hospitalized, PCR+/hospitalized, PCR+/intubated. Blood samples collected within 2 days admission/PCR testing. Metabolite concentration data, demographic data clinical propose develop optimal regression models diagnosis prognosis COVID-19. The area under receiver operating characteristic curve (AUC; 95% CI) was assess each models' predictive value. A panel included kynurenine: tryptophan ratio, lysoPC C26:0, pyruvic acid discriminated controls PCR+/not-hospitalized (AUC = 0.947; CI 0.931-0.962). second consisting C10:2, butyric acid, distinguished PCR+/hospitalized PCR+/intubated 0.975; 0.968-0.983). Only C28:0 differentiated patients 0.770; 0.736-0.803). If additional studies with confirm value these biomarkers, such panels could eventually be use in medical practice.

Language: Английский

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Drug-Induced Liver Injury in COVID-19 Patients: A Systematic Review

Frontiers in Medicine, Journal Year: 2021, Volume and Issue: 8

Published: Sept. 20, 2021

Introduction: The severity of COVID-19 may be correlated with the risk liver injury development. An increasing number studies indicate that degrees hepatotoxicity has been associated using some medications in management patients. However, limited had systematically investigated evidence drug-induced (DILI) Thus, this study aimed to examine DILI Methods: A systematic search was carried out PubMed/Medline, EMBASE, and Web Science up December 30, 2020. Search items included “SARS-CoV-2”, “Coronavirus,” COVID-19, injury. Results: We 22 related articles. Among studies, there five case report, series, four randomizes control trial (RCT), seven cohort one cross-sectional study. drugs review were remdesivir, favipiravir, tocilizumab, hydroxychloroquine, lopinavir/ritonavir. revealed a direct role drugs, while others couldn't certainly confirm due SARS-CoV-2 itself or administration medications. significant reported could attributable drug administration. Discussion: Liver patients caused by virus types drug. Intensive function monitoring should considered for patients, especially who are treated such as lopinavir/ritonavir, tocilizumab.

Language: Английский

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